SIALKOT MEDICAL COLLEGE

Test – 6th Periodical

July 22, 2019
Multiple Choice Questions
Note:
• Write Roll Number on MCQs Response Sheet
• Fill completely the appropriate box in MCQs Response
Sheet.

Total Number of MCQs : 35

15
Total Marks: 35 seconds
remaining
Time Allowed: 1 minute / MCQ
Q. 1. The most important effect of inadvertent
intravenous of a large dose of an amide local
anesthetic is:

a) Bronchoconstriction
b) Hepatic damage
c) Renal failure
d) Seizures
e) Tachycardia
15
seconds
remaining
Q. 2. A patient with Parkinson’s disease is experiencing
‘on-off’ effects with Levodopa. So it is combined with the
dopa decarboxylase inhibitor carbidopa and another drug
Z that inhibits the breakdown of levodopa into 3-O-
Methyldopa, a substance that competes with uptake of
levodopa into the brain. Which one of the following is the
other drug Z?
a) Amantadine
b) Bromocriptine
c) Entacapone
d) Pergolide 15
seconds
remaining
e) Selegiline
Q. 3. A patient with Parkinsonism and taking
medication is having ‘off’ periods of akinesia. Which
one of the following drugs given as a subcutaneous
injection will most likely provide temporary relief of
these off periods in this patient?
a) Amantadine
b) Apomorphine
c) Bromocriptine
d) Selegiline
15
e) Tolcapone seconds
remaining
Q. 4. A child requires multiple minor surgical
procedures involving the nasopharynx. Which drug
has high surface local anesthetic activity and
intrinsic vasoconstrictor actions that reduce bleeding
in mucous membranes?
a) Bupivacaine
b) Cocaine
c) Lidocaine
d) Mepivacaine
15
e) Tetracaine seconds
remaining
Q. 5. A 23-years-old man has a Pheochromocytoma, BP of
190/120 mm Hg, and hematocrit of 50%. Pulmonary
function and renal function are normal. His
catecholamines are elevated, and he has a well-defined
abdominal tumor on MRI. He has been scheduled for
surgery. Which one of the following agents should be
avoided in the anesthesia protocol?
a) Desflurane
b) Fentanyl
c) Isoflurane
15
d) Midazolam seconds
remaining

e) Sevoflurane
Q. 6. You have a vial containing 10 ml of a 2%
solution of Lidocaine. How much Lidocaine is
present in 1ml?
a) 2mg
b) 5mg
c) 10mg
d) 20mg
e) 50mg
15
seconds
remaining
Q. 7. If ketamine is used as the sole anesthetic
in the attempted reduction of a dislocated
shoulder joint, its actions will include
a) Analgesia
b) Bradycardia
c) Hypotension
d) Muscle rigidity
e) Respiratory depression
15
seconds
remaining
Q. 8. A patient develops prolong urinary and
faecal incontinence after being administered a
local anaesthetic. Which type of local
anaesthesia did he most likely receive?
a) Field block
b) Infiltration Anaesthesia
c) Regional anaesthesia
d) Spinal anaesthesia
e) Topical anaesthesia 15
seconds
remaining
Q. 9. Tolcapone may be of value in patients
being treated with levodopa-carbidopa because
it
a) Activates COMT
b) Decreases the formation of 3-O-methyldopa
c) Inhibits monoamine oxidase type A
d) Inhibits neuronal reuptake of dopamine
e) Releases dopamine from nerve endings
15
seconds
remaining
 Q. 10. Which of the following local anesthetics has a
short plasma half-life (approximately 20 minutes)
which a better therapeutic index and widespread
popularity in dental anaesthesia where it is generally
considered to be more effective, and possibly safer
then Lidocaine?
a) Articaine
b) Benzocaine
c) Bupivacaine
d) Lidocaine 15
seconds
remaining

e) Mepivacaine
Q. 11. With chronic use in seizure states, the
adverse effects of this drug include coarsening
of facial features, hirsutism, and gingival
hyperplasia.
a) Carbamazepine
b) Ethosuximide
c) Phenytoin
d) Tiagabine
15
e) Zonisamide seconds
remaining
Q. 12. Which of the following drugs may inhibit
the hepatic microsomal P450 responsible for
warfarin metabolism?
a) Amiodarone
b) Ethanol
c) Phenobarbital
d) Procainamide
e) Rifampin
15
seconds
remaining
Q. 13. A 78-year-old man with Parkinson disease
experiences worsening of his symptoms. He is already
taking levodopa. Since the disease is characterized by
degeneration of dopaminergic neurons, leading to the lack
of inhibition of cholinergic neurons, the addition of which
medication is likely to help alleviate the patient’s
symptoms?
a) Benztropine
b) Reserpine
c) Doxazocin
15
d) Timolol seconds
remaining

e) Tubocurarine
Q. 14. In Alzheimer’s disease, there is a deficiency of
cholinergic neuronal function in the brain. Theoretically,
which of the following strategies will be useful in treating
the symptoms of Alzheimer’s disease?

a) Inhibiting cholinergic receptors in the brain.

b) Inhibiting the release of acetylcholine in the brain.
c) Inhibiting the acetylcholinesterase enzyme in the brain.
d) Activating the acetylcholinesterase enzyme in the brain.
e) Inhibiting the release of dopamine. 15
seconds
remaining
Q. 15. With chronic use in seizure states, the
adverse effects of this drug include coarsening
of facial features, hirsutism, and gingival
hyperplasia.
a) Carbamazepine
b) Ethosuximide
c) Phenytoin
d) Tiagabine
15
e) Zonisamide seconds
remaining
Q. 16. The most important effect of inadvertent
intravenous administration of a large dose of
lidocaine is:
a) Bronchoconstriction
b) Methemoglobinemia
c) Renal failure
d) Seizures
e) Tachycardia
15
seconds
remaining
Q. 17. A patient with known
pseudocholinestrase deficiency is to be given a
local anesthetic for a minor surgical procedure.
Which one of the following local anesthetics will
he most likely be administered?
a) Benzocaine
b) Procaine
c) Ropivacaine
d) Tetracaine 15
seconds

e) Cocaine
remaining
Q. 18. Which one of the following is among
the newer sedative hypnotics?
a) Chloral hydrate
b) Hydroxyzine
c) Meprobamate
d) Paraldehyde
e) Zolpidem
15
seconds
remaining
Q. 19. The elimination half-life of which of
the following drug is around 4-5 days?
a) Amylobarbitone
b) Pentobarbitone
c) Phenobarbitone
d) Secobarbitone
e) Thiopentone
15
seconds
remaining
Q. 20. Which one of the following drugs is
more potent, rapidly eliminated, and
produces more frequent and sever
withdrawal problems?
a) Alprazolam
b) Diazepam
c) Flurazepam
d) Temazepam 15
seconds

e) Triazolam remaining
Q. 21. A 31-year-old man is diagnosed with schizophrenia.
He is treated for 2 days with a neuroleptic and now
becomes rigid, appears confused and develops a fever of
105 F. Therapy with a neuroleptic is stopped and supportive
measures are taken. Which of the following drugs should
also be given?
a) Amoxapine
b) Dantrolene
c) Fluoxetine
d) Lithium 15

e) Phenobarbitone seconds
remaining
Q. 22. A 35-year-old female has schizophrenia and has been
treated with various medications. She is now receiving
Fluphenazine and after some time starts complaining of
amenorrhoea and galactorrhoea. You should switch her to
which one of the following drugs?
a) Chlorpromazine
b) Haloperidol
c) Olanzapine
d) Promethazine
e) Thioridazine 15
seconds
remaining
Q. 23. A 43-years-old patient has a low white
blood cell count due to a chronic disease. He is
carefully administered a drug that increase white
blood cell count. Which one of the following
drugs is he most likely administered?
a) Clozapine
b) Levodopa
c) Lithium
d) Risperidone 15
seconds

e) Selegiline
remaining
Q. 24. A patient has diagnosed with
Schizophrenia. He is prescribed a typical anti-
psychotic that has decreased potency. He should
be most likely warned about which one of the
following adverse effects?
a) Diarrhoea
b) Increased salivation
c) Increased sweating
d) Nausea and vomiting 15
seconds

e) Postural Hypotension remaining

Q. 25. Chlorpromazine and many other typical
anti-psychotics increase the secretion of which of
the following hormones?
a) ACTH
b) ADH
c) GnRH
d) Growth Hormones
e) Prolactin
15
seconds
remaining
Q. 26. Which of the following drugs is preferred
for the treatment of a typical depression
(Hyperphagia, increased appetite, mood
reactivity and highly sensitive) in a patient who is
not responding to first line drugs?
a) Amitriptyline
b) Fluoxetine
c) Mirtazapine
d) Phenelzine 15
seconds
remaining

e) Trazodone
Q. 27. An old patient has major depression after his wife
dead and his children have moved out of town. The
medical records show he has had 2 myocardial infarcts
over the past 10 years and a history of intermittent 2nd
degree heart block. Which of the following drugs would
be most suitable for treating his depression?
a) Amitriptyline
b) Desipramine
c) Fluoxetine
d) Imipramine 15
seconds
e) Phenelzine remaining
Q. 28. A depressed patient taking anti-depressant
medication goes to McDonalds with his family to ‘lighten
up’ his mood. He has an excess intake of cheese and
ketchup. Shortly after words he ends up in the
emergency room with abnormally elevated blood
pressure. Which one of the following medications was
most likely responsible for his condition?
a) Bupropion
b) Fluoxetine
c) Imipramine
15
d) Phenelzine seconds
remaining

e) Trazodone
Q. 29. A patient is suffering from major depression since he
last 2 years and has been prescribed several anti- depressant
one after another, but he stops talking each one of them
after several weeks because of complaint of sexual
dysfunction. Which one of the following anti-depressant will
you prescribe him now that is least likely to cause this side
effect?
a) Amitriptyline
b) Bupropion
c) Fluoxetine
d) Paroxetine 15
seconds

e) Phenelzine remaining
Q. 30. A young male was brought to the emergency room by the
police due to severe agitation. Psychiatric examination revealed
that he had injected Dextroamphetamine several times in the past
few days, the last time being 10 hours previously. He was given a
drug that sedated him, and he fell asleep. Which of the following
drugs was most likely used to counter this patient’s apparent
symptoms of Dextroamphetamine withdrawal?
a) Phenobarbital.
b) Lorazepam.
c) Cocaine.
d) Hydroxyzine.
15
e)Fluoxetine. seconds
remaining
Q. 31. A 10-year-old male boy who is sent to a pediatric neurologist for an
evaluation due to receiving poor grades in class. Boy’s parents have recently
received complaints from his teacher that he is performing poorly in school
and he is repeatedly caught not paying attention in class. Several times a day
during class, boy is noted to be getting out of his chair and socializing with
other students. He has also been getting into fights with some children, as he
is being singled out by others and teased. The boy is given a diagnosis of
ADHD with impulsivity and irritability. Which of the following is the most
appropriate recommendation for management of the ADHD?
a) Clonidine.
b) Caffeine.
c) Dextroamphetamine.
d) Haloperidol.
15
e) Buspirone. seconds
remaining
Q. 32. Which of the following agents is
considered a first-line treatment for narcolepsy?
a) Donepezil.
b) Atomoxetine.
c) Clonidine.
d) Temazepam.
e) Modafinil.
15
seconds
remaining
Q. 33. A 34-year-old male patient who was prescribed citalopram
for depression has decided he wants to stop taking the drug.
When questioned, he said that it was affecting his sexual
performance.
You ascertain that he is also trying to overcome his
dependency on tobacco products. If you decide to reinstitute
drug therapy in this patient, the best choice would be
a) Amitriptyline
b) Bupropion
c) Fluoxetine
d) Imipramine
15
e) Venlafaxine seconds
remaining
Q. 34. A recently widowed 76-year-old female patient was treated
with a benzodiazepine for several weeks after the death of her
husband, but she did not like the daytime sedation it caused even
at low dosage. Living independently, she has no major medical
problems but appears rather infirm for her age and has poor
eyesight. Because her depressive symptoms are not abating, you
decide on a trial of an antidepressant medication. Which of the
following drugs would be the most appropriate choice for this
patient?
a) Amitriptyline
b) Citalopram
c) Mirtazapine
15
d) Phenelzine seconds
remaining

e) Trazodone
Q. 35. SSRIs are much less effective than tricyclic
antidepressants in the management of
(A) Bulimia
(B) Chronic pain of neuropathic origin
(C) Generalized anxiety disorder
(D) Obsessive-compulsive disorder
(E) Premenstrual dysphoric disorder
15
seconds
remaining
 Department of Pharmacology & Therapeutics
Sialkot Medical College, Sialkot
6th Periodical Test Monday; 22 July 2019
SEQs Section (55 min. Time) Max. Marks: 35
Attempt ALL Questions
1. a) Give chemical classification of Benzodiazepine? 03
b) Classify long acting barbiturates? 02
2. a) What are pre-anesthetic drug, Enumerate names & benefits? 05
3. Classify 2nd generation Antipsychotic drugs. 05
4. a) Classify Antiepileptic drugs? 03
b) Antiepileptic drugs contra-indicated in Petit mal epilepsy & why? 02
5. a) Classify SSRIs. 03
b) Therapeutic uses of SSRIs 02
6. a) Name different drug groups uses in the treatment of Parkinson disease? 03
b) What is Alcoholism & Pharmacotherapy treatment of Alcoholism? 02
7. Define with example following with examples: 05
a) Analeptics
b) Neuroleptics
c) Psycholeptics